| NPI | 1407716079 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA067159) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA OA007476) |
| Enumeration Date | 2025-11-14 |
| Last Update Date | 2026-02-11 |